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Pleural effusion exudate

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https://www.readbyqxmd.com/read/29768381/tuberculous-pleurisy-mimicking-mycoplasma-pneumoniae-infection-in-a-previously-healthy-young-adult-a-case-report
#1
Daizo Yaguchi, Motoshi Ichikawa, Masato Shizu, Noriko Inoue, Daisuke Kobayashi, Naoyuki Imai, Masao Ito
RATONALE: Sometimes, pleural effusion accompanying an acute Mycoplasma pneumoniae infection or tuberculous pleurisy has similar analysis results. We report a case of tuberculous pleurisy which was initially diagnosed as acute M pneumoniae infection, which is of special interest because anti-Mycoplasma antibody results were positive, which served as a red herring. PATIENT CONCERNS: A 20-year-old woman visited the outpatient emergency romm of our hospital for chief complaints of high fever, dry cough, and pleuralgia persiting for 2 days...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29755068/-tuberculous-pleurisy-diagnosed-by-thoracoscopic-lung-biopsy
#2
Jun Yamamoto, Miho Nishiura, Takanori Ohata, Ho Namkoong, Shinji Sakaguchi, Fumitake Saito, Hideki Yuki
A 44-year-old woman was referred to our hospital with pleural effusion and unknown fever. Mycobacterium tuberculosis was not detected by culture of pleural effusion and sputum and gastric fluid. Pleural fluid was serous and exudative, and cytological examination showed no malignant cells. Computed tomography revealed a little pleural thickening of the right middle lobe and massive pleural effusion. As acute pleurisy was suspected based on the findings of imaging studies, thoracoscopy was performed under general anesthesia...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29735508/carbimazole-induced-eosinophilic-pleural-effusion
#3
Chris Ferguson, Claire Bradley, Joe Kidney
We report the case of a 41-year-old woman who presented with a unilateral exudative effusion with prominent eosinophils on pleural cytology. Carbimazole had been started 4 weeks prior to presentation. No immediate cause was identified on imaging or laboratory testing. The effusion persisted at 2-month follow-up. Further investigation at this time, including autoimmune serology was negative. At 2-month follow-up, the effusion was loculated on ultrasound imaging and had a low fluid pH on diagnostic aspiration, in keeping with an empyema...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29719802/xanthomatous-pleuritis
#4
Ranjit Kumar Singh, Sanjib Pattari
This case presentation relates to a 21 year young male, cachectic in appearance, who presented with progressive shortness of breath, and dull pain on the lower part of the chest ongoing over three months. The patient received antitubercular drugs by local physician for suspected tuberculosis with no significant improvement. He was referred to our Respiratory Department for further evaluation of his chest pain and breathlessness. His X-ray showed moderate pleural effusion on the left side which confirmed by USG chest screening which showed multiple septation with thick parietal pleura and USG abdomen was normal...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29719749/a-case-of-transudative-chylothorax-a-diagnostic-dilemma
#5
Kartikeya Rajdev, Akshay Avula, Dikshya Sharma, Wissam Mansour, Shivika Agarwal, Abdul Hasan Siddiqui, Michel Chalhoub
Chylothorax is a type of pleural effusion characterized by the presence of chyle in the pleural space with triglyceride levels >110 mg/dL or evidence of chylomicrons in pleural fluid. Chylous effusion is typically exudative in nature with lymphocytic predominance. Transudative chylothorax is a rare finding which has been associated with only a limited range of clinical settings. We report a case of idiopathic transudative chylothorax for which the etiological cause could not be identified despite extensive workup and it resolved spontaneously after thoracentesis...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29701188/-clinical-value-of-surfactant-protein-a-in-exudate-pleural-effusion
#6
Jing Guan, Jianmin Li, Yang Wang, Zhiguang Liu, Xiaoping Long, Chanyuan Pan
To evaluate the clinical value of surfactant protein-A (SP-A) in exudate pleural effusion (EPE).
 Methods: This clinical study was prospective, observational and cross-sectional. Two hundred and fifteen patients with pleural effusion were divided into the transudate pleural effusions (TPE) group and the EPE group. TPE patients served as the control group. The concentrations of pleural effusions SP-A (SP-Apl) and serum SP-A (SP-Ase) were measured by ELISA, and receiver operator characteristic (ROC) curve and multivarate Cox analysis of SP-A was analysed for its clinical value...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29687517/hounsfield-units-are-a-useful-predictor-of-pleural-effusion-cytological-type-in-dogs-but-not-in-cats
#7
Sarah J Woods, Mathieu Spriet, Noa Safra, Derek D Cissell, Dori L Borjesson
All categories of pleural effusion subjectively display as soft tissue opacity on computed tomography (CT). Quantitative measurement using Hounsfield units (HU) has the potential to bring additional information regarding the nature of the fluid in a noninvasive way. The purposes of this retrospective cross-sectional analytical study were to compare Hounsfield units of different pleural effusion categories in dogs and cats, assess association between specific cytologic parameters and Hounsfield units, and evaluate the effect of dependent vs...
April 23, 2018: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29660258/pleural-tuberculosis-a-concise-clinical-review
#8
Jane A Shaw, Elvis M Irusen, Andreas H Diacon, Coenraad Fn Koegelenberg
Tuberculosis (TB) is the leading infectious cause of death worldwide, and the commonest cause of death in people living with HIV. Globally, pleural TB remains one of the most frequent causes of pleural exudates, particularly in TB-endemic areas and in the HIV positive population. Most TB pleural effusions are exudates with high adenosine deaminase (ADA), lymphocyte-rich, straw-coloured and free flowing, with a low yield on mycobacterial culture. TB pleurisy can also present as loculated neutrophil-predominant effusions which mimic parapneumonic effusions...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29629675/the-current-aetiology-of-malignant-pleural-effusion-in-the-western-cape-province-south-africa
#9
C F N Koegelenberg, S M Bennji, E Boer, P T Schubert, J A Shaw, B W Allwood, E M Irusen
BACKGROUND: Malignant pleural effusion (MPE) represents a very common cause of pleural exudates, and is one of the most challenging pleural disorders to manage. This could be attributed to the paucity of high-quality experimental evidence, and inconsistent practice worldwide. South Africa (SA) currently has no data regarding the aetiology of MPE. OBJECTIVES: To identify the most common malignancies causing MPE in a population served by a large tertiary hospital in SA, and specifically the relative contribution of mesothelioma...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29615010/malignant-pleural-mesothelioma-diagnostic-value-of-medical-thoracoscopy-and-long-term-prognostic-analysis
#10
Li-Li Xu, Yuan Yang, Zhen Wang, Xiao-Juan Wang, Zhao-Hui Tong, Huan-Zhong Shi
BACKGROUND: Malignant pleural mesothelioma (MPM) is marked by its difficult diagnosis and poor prognosis. Medical thoracoscopy (MT) is an effective and safe procedure for the diagnosis of exudative pleural effusions and many factors associated with poor prognosis of MPM. We conducted this study to investigate the value of MT for diagnosing of MPM and to identify prognostic factors for MPM patients. METHODS: From July 2005 through June 2014, a total of 833 patients with undiagnosed pleural effusions underwent MT and pleural biopsies were taken...
April 3, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29610630/feasibility-and-safety-of-pleuroscopic-cryobiopsy-of-the-pleura-a-prospective-study
#11
Chia-Hung Chen, Wen-Chien Cheng, Biing-Ru Wu, Chih-Yu Chen, Wei-Chun Chen, Wei-Chih Liao, Chih-Yen Tu
Background: The aim of this study was thus to evaluate the feasibility and safety of taking biopsy specimens by cryoprobe from the parietal pleura during semirigid pleuroscope. Methods: In a single-center, observational, prospective study, patients with exudative pleural effusion (EPE) were evaluated with a semirigid pleuroscope between January 2015 and July 2017. Each patient underwent pleural biopsy using flexible forceps and flexible cryoprobe through pleuroscope following diagnostic thoracentesis and closed pleural biopsy (CPB)...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29592999/treatment-of-refractory-rheumatoid-pleural-effusion-with-abatacept
#12
Shunichi Fujita, Tomoyuki Mukai, Takahiko Akagi, Yoshitaka Morita
Rheumatoid pleural effusion is generally responsive to corticosteroids, but refractory cases require consideration of second-line therapy. Here we report the case of a 61-year-old man with rheumatoid arthritis (RA) who developed a large right-sided pleural effusion and was successfully treated with abatacept. Thoracocentesis showed a sterile exudate and an elevated adenosine deaminase level. The methotrexate and etanercept used to treat the RA were withheld initially while he underwent a trial of prednisolone 40 mg/day for the pleural effusion...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29577922/efficacy-and-cost-of-awake-thoracoscopy-and-video-assisted-thoracoscopic-surgery-in-the-undiagnosed-pleural-effusion
#13
Christine M McDonald, Camille Pierre, Marc de Perrot, Gail Darling, Marcelo Cypel, Andrew Pierre, Thomas Waddell, Shaf Keshavjee, Kazuhiro Yasufuku, Kasia Czarnecka-Kujawa
BACKGROUND: The study aim is to compare the diagnostic yield, safety and cost of outpatient awake thoracoscopy (AT) to video-assisted thoracoscopic surgery (VATS) pleural biopsy in undiagnosed pleural effusions. METHODS: The diagnostic yield of pleural biopsy performed by AT or VATS in patients with undiagnosed exudative pleural effusions at a tertiary Thoracic Surgery center in Canada between 2011-2015 was retrospectively evaluated. Test sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were compared...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29518849/-respiratory-manifestations-of-yellow-nail-syndrome-report-of-two-cases-and-literature-review
#14
S Li, H Huang, K Xu, Z J Xu
Objective: To describe the clinical characteristics of respiratory manifestations of yellow nail syndrome. Methods: We conducted a retrospective analysis of 2 patients with respiratory diseases associated with yellow nail syndrome. Their clinical and chest radiological data were collected. We searched PubMed, Wanfang and CNKI databases with the keywords "yellow nail syndrome, yellow nail and lung" in Chinese and English. And the relevant literatures, including 6 articles in Chinese and 81 articles in English, were reviewed...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29503942/drainage-and-analysis-of-suprachoroidal-fluid-in-a-patient-with-acute-systemic-lupus-erythematous
#15
James A Stefater, Dean Eliott, Leo A Kim
Purpose: To describe a case of a patient with acute systemic lupus erythematous (SLE) causing choroidal effusions and to report a novel technique for evaluation of the choroidal fluid which sheds light on effusion pathogenesis. Observations: A 37 year-old woman was referred for decreased vision, eye pain and shortness of breath. The patient had bilateral angle closure glaucoma from choroidal effusions and bilateral pleural effusions. Work-up revealed new onset acute SLE...
April 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29496288/detection-of-pleural-fluid-biochemistry-changes-in-two-consecutive-thoracenteses-for-differentiating-malignant-from-benign-effusions
#16
Silvia Bielsa, Alberto García-Zamalloa, Paula Monteagudo, Didac González-Sans, David Ascanio, Aureli Esquerda, Jorge Taboada-Gómez, José M Porcel
OBJECTIVE: To assess whether changes in pleural fluid (PF) biochemistries between two consecutive thoracenteses enable clinicians to predict malignant or benign pleural effusions (PE). METHODS: Retrospective study of patients with lymphocytic exudates and negative PF cytology, who underwent a second thoracentesis in our center in the last 15 years in whom a final diagnosis was reached (derivation sample). Absolute (Δa) and percentage differences (Δp) in PF biochemistries which predicted a malignant or benign PE in the derivation sample were evaluated in an independent population (validation sample)...
February 26, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29411725/vascular-endothelial-growth-factor-in-pleural-effusions-and-correlation-with-radiologic-and-biochemical-parameters
#17
N Bayram, Y Karakan, M Uyar, B Ozyurt, A Filiz
INTRODUCTION: Pleural effusion is a common clinical problem with management difficulties. The aim of this study is to evaluate vascular endothelial growth factor (VEGF) in differential diagnosis of pleural effusions and the presence of correlation between radiological features and biochemical properties. MATERIALS AND METHODS: The study included patients with pleural effusion. VEGF levels in the pleural fluid were measured by enzyme-linked immunosorbent assay. RESULTS: A total of 97 patients who had exudative pleural effusion related to lung cancer (n = 17), nonpulmonary malignancies (n = 25), mesothelioma (n = 9), pneumonia (n = 14), tuberculosis (n = 8), miscellaneous causes (n = 6), and transudative effusion (n = 18) were included...
January 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29408477/development-of-a-clinical-prediction-rule-for-the-diagnosis-of-pleural-tuberculosis-in-peru
#18
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: To develop a clinical prediction rule (CPR) for the diagnosis of pleural tuberculosis (PT) in patients with pleural exudates in Peru. METHODS: Clinical and laboratory information was collected from patients with exudative pleural effusion attending two reference hospitals in Lima, Peru. Predictive findings associated with PT in a multiple logistic regression model were used to develop the CPR. A definite diagnosis of PT was based on a composite reference standard including bacteriological and/or histological analysis of pleural fluid and pleural biopsy specimens...
April 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29394534/-local-control-of-advanced-breast-cancer-with-giant-ulcer
#19
Tomoo Inoue, Atsushi Shimomura, Takuji Sugimoto, Shiori Wakamiya, Ukou Chou, Akira Fujiwara, Fumihiro Uchikoshi, Tarou Watanabe, Natsuko Kitamura
This study reports the treatment and local control of advanced breast cancer with a giant ulcer. A 53-year-old woman presented with a large left breast tumor and an associated giant ulcer, with massive exudates, bleeding, and an offensive odor. Histopathological examination revealed an invasive ductal carcinoma(Luminal B type). Computed tomography(CT) showed multiple metastases to the lymph nodes, lungs, liver and bones. The patient received chemotherapy with a combina- tion of paclitaxel(PTX 90mg/m / 2)and bevacizumab(BEV 10 mg/kg)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29368890/-diagnostic-rentability-of-close-pleural-biopsy-tru-cut-vs-cope
#20
Héctor Glenn Valdez-López, Alma Iris Cano-Rodríguez, Mario Montemayor-Chapa, Juan Francisco Castillo-Sánchez
BACKGROUND: The prevalence of pleural effusion in Mexico is over 400 per 100 000 inhabitants. The etiology is infectious in 45.7% and neoplastic in 32.6%. Closed pleural biopsy sensibility is 48-70% in cancer and 50-59% in tuberculosis using Cope or Abrams needle. In 1989, Tru-cut needle biopsy was described in a small study for massive pleural effusions with a sensibility of 86%. Our Institute has a wide experience with this infrequently procedure with reliable results than using Cope needle...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
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